{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:38:56Z","timestamp":1790757536721,"version":"4.1.0"},"reference-count":79,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ABBOTT LABORATORIES (AL) S.A.","award":["CIF: A08099681"],"award-info":[{"award-number":["CIF: A08099681"]}]},{"name":"ABBOTT LABORATORIES (AL) S.A.","award":["EM-0000185602-RA\/884463"],"award-info":[{"award-number":["EM-0000185602-RA\/884463"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Malnutrition and sarcopenia are highly prevalent and clinically impactful conditions in patients undergoing maintenance hemodialysis (MHD), yet their early detection remains challenging. This study aimed to assess the diagnostic performance of nutritional ultrasonography (NUS) in the morphofunctional evaluation of malnutrition and sarcopenia, and to compare its utility with established tools such as bioimpedance analysis (BIA), biochemical markers, handgrip strength (HGS), and functional performance tests. Materials and Methods: A cross-sectional study was conducted in 74 stable MHD patients. Clinical, analytical, anthropometric, BIA, NUS, and functional parameters were collected, along with validated nutritional and frailty scales. NUS was used to assess the quadriceps rectus femoris (QRF) and preperitoneal visceral fat (PPVF), measuring Y-axis, Y-axis\/height, cross-sectional muscle area rectus femoris (CS-MARF), muscle area rectus femoris index adjusted to height (MARFIh), and supramuscular fat (SMF). Sarcopenia was defined according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Results: The prevalence of risk, confirmed, and severe sarcopenia was 24.3%, 40.5%, and 20.3%, respectively. Severe-to-moderate protein-energy wasting (PEW) affected 44.6% of patients. Compared to non-sarcopenic individuals, sarcopenic patients had lower values of HGS, prealbumin, lean body mass, and phase angle. NUS-derived cut-off values for sarcopenia were Y-axis \u2264 8 mm, Y-axis\/height \u2264 2.9 mm\/m2, CS-MARF \u2264 2.4 cm2, and MARFIh \u2264 0.9 cm2\/m2. The most discriminative NUS parameters were Y-axis and SMF (AUC 0.67), followed by Y-axis\/height (AUC 0.65) and MARFIh (AUC 0.63). NUS measurements correlated significantly with ASMI, phase angle, HGS, and SPPB scores. Conclusions: Nutritional ultrasonography is a feasible, reproducible, and clinically valuable tool for assessing muscle mass and quality in MHD patients. Its incorporation into routine practice may enhance early detection of malnutrition and sarcopenia, thereby facilitating timely, individualized nutritional interventions.<\/jats:p>","DOI":"10.3390\/medicina61061044","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T11:04:06Z","timestamp":1749121446000},"page":"1044","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Morphofunctional Assessment of Malnutrition and Sarcopenia Using Nutritional Ultrasonography in Patients Undergoing Maintenance Hemodialysis"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9346-2279","authenticated-orcid":false,"given":"Jos\u00e9 C.","family":"De La Flor","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"},{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"},{"name":"Health Sciences Doctoral Program, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4538-3503","authenticated-orcid":false,"given":"Estefanya","family":"Garc\u00eda-Men\u00e9ndez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7481-3678","authenticated-orcid":false,"given":"Gregorio","family":"Romero-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Grupo REMAR-IGTP, Department of Nephrology, Hospital Germans Trias i Pujol, Instituto de Investigaci\u00f3n Germans Trias i Pujol (IGTP), 08916 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Rodr\u00edguez Tudero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"},{"name":"PhD in Surgery Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3005-7039","authenticated-orcid":false,"given":"Elena","family":"Jim\u00e9nez Mayor","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital San Pedro de Alc\u00e1ntara, 10001 C\u00e1ceres, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Florit Mengual","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Sistemes Renales Hemodialysis Clinic, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3690-6598","authenticated-orcid":false,"given":"Esperanza","family":"Moral Berrio","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Soria Morales","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-7231","authenticated-orcid":false,"given":"Michael","family":"Cieza Terrones","sequence":"additional","affiliation":[{"name":"Department of Engineering, Faculty of Science and Engineering, Peruana Cayetano Heredia University, Lima 15002, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Secundino","family":"Cigarr\u00e1n Guldris","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Ribera Polusa, 27004 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Hern\u00e1ndez Vaquero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease: An update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int. Suppl."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/S0140-6736(19)32977-0","article-title":"The global burden of chronic kidney disease","volume":"395","author":"Cockwell","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1053\/j.jrn.2024.08.003","article-title":"Assessment Criteria to Diagnose Malnutrition (Undernutrition and Overnutrition) in Hemodialysis Patients","volume":"35","author":"Aziz","year":"2024","journal-title":"J. Ren. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100855","DOI":"10.1016\/j.cegh.2021.100855","article-title":"Estimates of malnutrition associated with chronic kidney disease patients globally and its contrast with India: An evidence based systematic review and meta-analysis","volume":"12","author":"Rashid","year":"2021","journal-title":"Clin. Epidemiol. Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.clnu.2015.03.001","article-title":"Diagnostic criteria for malnutrition\u2014An ESPEN Consensus Statement","volume":"34","author":"Cederholm","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN guidelines on definitions and terminology of clinical nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s12603-022-1774-z","article-title":"A Clinically Relevant Diagnosis Code for \u201cMalnutrition in Adults\u201d Is Needed in ICD-11","volume":"26","author":"Cederholm","year":"2022","journal-title":"J. Nutr. Health Aging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1038\/sj.ki.5002585","article-title":"A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease","volume":"73","author":"Fouque","year":"2008","journal-title":"Kidney Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"38","author":"Cederholm","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.nefro.2023.08.001","article-title":"Definici\u00f3n y evoluci\u00f3n del concepto de sarcopenia","volume":"44","year":"2024","journal-title":"Nefrolog\u00eda"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1007\/s12603-014-0505-5","article-title":"Prevalence of sarcopenia in elderly maintenance hemodialysis patients: The impact of different diagnostic criteria","volume":"18","author":"Lamarca","year":"2014","journal-title":"J. Nutr. Health Aging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1093\/ndt\/gft070","article-title":"Uraemic sarcopenia: Aetiology and implications","volume":"29","author":"Fahal","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_14","first-page":"1","article-title":"Nuevo enfoque de la nutrici\u00f3n. Valoraci\u00f3n del estado nutricional del paciente: Funci\u00f3n y composici\u00f3n corporal","volume":"35","author":"Aguilar","year":"2018","journal-title":"Nutr. Hosp."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Yang, Q., Zhang, C., Zhang, Z., and Su, B. (2024). Muscle ultrasound to diagnose sarcopenia in chronic kidney disease: A systematic review and bayesian bivariate meta-analysis. BMC Nephrol., 25.","DOI":"10.1186\/s12882-023-03445-2"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.endinu.2022.03.008","article-title":"Nutritional ultrasound\u00ae: Conceptualisation, technical considerations and standardisation","volume":"70","author":"Guerrero","year":"2023","journal-title":"Endocrinol. Diabetes. Nutr."},{"key":"ref_17","unstructured":"International Society for the Advancement of Kinanthropometry (2025, March 30). International Standards for Anthropometric Assessment\u2014ScienceOpen. Available online: https:\/\/www.scienceopen.com\/document?vid=ccde4859-d1c7-4ea6-92b8-37d48744f862."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/sj.ejcn.1602049","article-title":"Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis","volume":"59","author":"Sartorio","year":"2005","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_19","unstructured":"(2025, March 30). InBody S10 USER\u2019S MANUAL. Available online: http:\/\/www.inbody.com."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3288","DOI":"10.1016\/j.clnu.2020.10.056","article-title":"Development and validation of a multifrequency bioimpedance spectroscopy equation to predict appendicular skeletal muscle mass in hemodialysis patients","volume":"40","author":"Lin","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/02701367.1999.10608028","article-title":"A 30-s chair-stand test as a measure of lower body strength in community-residing older adults","volume":"70","author":"Jones","year":"1999","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_22","unstructured":"(2025, March 30). Short Physical Performance Battery (SPPB)|National Institute on Aging, Available online: https:\/\/www.nia.nih.gov\/research\/labs\/leps\/short-physical-performance-battery-sppb."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Beaudart, C., McCloskey, E., Bruy\u00e8re, O., Cesari, M., Rolland, Y., Rizzoli, R., Araujo De Carvalho, I., Amuthavalli Thiyagarajan, J., Bautmans, I., and Berti\u00e8re, M.-C. (2016). Sarcopenia in daily practice: Assessment and management. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0349-4"},{"key":"ref_24","unstructured":"(2025, March 31). A Formula to Estimate the Approximate Surface Area If Height and Weight Be Known, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/2520314\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s40620-019-00659-2","article-title":"Validation by CT scan of quadriceps muscle thickness measurement by ultrasound in acute kidney injury","volume":"33","author":"Sabatino","year":"2020","journal-title":"J. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/S0899-9007(99)00084-2","article-title":"Development of a valid and reliable malnutrition screening tool for adult acute hospital patients","volume":"15","author":"Ferguson","year":"1999","journal-title":"Nutrition"},{"key":"ref_27","unstructured":"(2025, April 06). Reliability of the 7-Point Subjective Global Assessment Scale in Assessing Nutritional Status of Dialysis Patients, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/10682107\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1053\/j.jrn.2014.06.008","article-title":"A simple protein-energy wasting score predicts survival in maintenance hemodialysis patients","volume":"24","author":"Jean","year":"2014","journal-title":"J. Ren. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1053\/ajkd.2001.29222","article-title":"A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients","volume":"38","author":"Kopple","year":"2001","journal-title":"Am. J. Kidney Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","article-title":"Frailty consensus: A call to action","volume":"14","author":"Morley","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0272-6386(12)81083-3","article-title":"Malnutrition in hemodialysis patients","volume":"21","author":"Hakim","year":"1993","journal-title":"Am. J. Kidney Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/j.ajkd.2020.05.006","article-title":"KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update","volume":"76","author":"Burrowes","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Macedo, C., Amaral, T.F., Rodrigues, J., Santin, F., and Avesani, C.M. (2021). Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.721941"},{"key":"ref_34","unstructured":"(2025, April 19). Assessment of Methods to Identify Protein-Energy Wasting in Patients on Hemodialysis\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/21541464\/."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"787","DOI":"10.3945\/ajcn.2008.26970","article-title":"Subjective global assessment of nutritional status is strongly associated with mortality in chronic dialysis patients 1\u20134","volume":"89","author":"Grootendorst","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"219","DOI":"10.7762\/cnr.2021.10.3.219","article-title":"Comparison of the Nutritional Status Assessment Methods for Hemodialysis Patients","volume":"10","author":"Sohrabi","year":"2021","journal-title":"Clin. Nutr. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1681\/ASN.V121157","article-title":"Renal function and nutritional status at the start of chronic dialysis treatment","volume":"12","author":"Jansen","year":"2001","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1017\/S0007114519000400","article-title":"Criteria for classification of protein-energy wasting in dialysis patients: Impact on prevalence","volume":"121","author":"Mahillo","year":"2019","journal-title":"Br. J. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1053\/j.jrn.2018.08.006","article-title":"Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism","volume":"28","author":"Carrero","year":"2018","journal-title":"J. Ren. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Arias-Guill\u00e9n, M., Collado, S., Coll, E., Carreras, J., Betancourt, L., Romano, B., Fern\u00e1ndez, M., Duarte, V., Garro, J., and Soler, J. (2022). Prevalence of Protein-Energy Wasting in Dialysis Patients Using a Practical Online Tool to Compare with Other Nutritional Scores: Results of the Nutrendial Study. Nutrients, 14.","DOI":"10.3390\/nu14163375"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"741","DOI":"10.23876\/j.krcp.21.278","article-title":"Association of sarcopenia and its components with clinical outcomes in patients undergoing peritoneal dialysis","volume":"41","author":"Kang","year":"2022","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.2215\/CJN.10261013","article-title":"Comparative associations of muscle mass and muscle strength with mortality in dialysis patients","volume":"9","author":"Isoyama","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Zicarelli, M., Duni, A., Leivaditis, K., Lin, Y.L., Baciga, F., Pugliese, S., Fiorentino, M., Hsu, B.-G., Roumeliotis, S., and Battaglia, Y. (2025). Comprehensive Insights into Sarcopenia in Dialysis Patients: Mechanisms, Assessment, and Therapeutic Approaches. Medicina, 61.","DOI":"10.3390\/medicina61030449"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1002\/jcsm.13425","article-title":"Prevalence of sarcopenia in patients with chronic kidney disease: A global systematic review and meta-analysis","volume":"15","author":"Duarte","year":"2024","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Wathanavasin, W., Banjongjit, A., Avihingsanon, Y., Praditpornsilpa, K., Tungsanga, K., Eiam-Ong, S., and Susantitaphong, P. (2022). Prevalence of Sarcopenia and Its Impact on Cardiovascular Events and Mortality among Dialysis Patients: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14194077"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40200-017-0302-x","article-title":"Prevalence of sarcopenia in the world: A systematic review and meta- analysis of general population studies","volume":"16","author":"Shafiee","year":"2017","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.clnu.2013.04.002","article-title":"Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease","volume":"33","author":"Kim","year":"2014","journal-title":"Clin. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.nefro.2024.12.004","article-title":"Ecograf\u00eda POCUS: Una herramienta para la detecci\u00f3n y seguimiento de sarcopenia en di\u00e1lisis peritoneal","volume":"45","year":"2025","journal-title":"Nefrolog\u00eda"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/jcsm.12890","article-title":"Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: A systematic review and meta-analysis","volume":"13","author":"Shu","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1053\/j.jrn.2019.09.004","article-title":"Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients","volume":"30","author":"Slee","year":"2020","journal-title":"J. Ren. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1152\/jappl.2000.89.2.465","article-title":"Estimation of skeletal muscle mass by bioelectrical impedance analysis","volume":"89","author":"Janssen","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1177\/0884533617696331","article-title":"Differences in Prevalence of Muscle Wasting in Patients Receiving Peritoneal Dialysis per Dual-Energy X-Ray Absorptiometry Due to Variation in Guideline Definitions of Sarcopenia","volume":"32","author":"Hung","year":"2017","journal-title":"Nutr. Clin. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ng, J.K.C., Lau, S.L.F., Chan, G.C.K., Tian, N., and Li, P.K.T. (2023). Nutritional Assessments by Bioimpedance Technique in Dialysis Patients. Nutrients, 16.","DOI":"10.3390\/nu16010015"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/j.clnu.2019.06.023","article-title":"Assessment of bioelectrical phase angle as a predictor of nutritional status in patients with Croh\u2019s disease: A cross sectional study","volume":"39","author":"Cioffi","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1053\/j.jrn.2018.09.001","article-title":"Bioelectrical Impedance Analysis-Derived Phase Angle Predicts Protein-Energy Wasting in Maintenance Hemodialysis Patients","volume":"29","author":"Tan","year":"2019","journal-title":"J. Ren. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s41999-020-00433-9","article-title":"Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update","volume":"12","author":"Perkisas","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s40520-018-0958-1","article-title":"Assessing sarcopenia with vastus lateralis muscle ultrasound: An operative protocol","volume":"30","author":"Ticinesi","year":"2018","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1002\/jcsm.12210","article-title":"The reliability and validity of ultrasound to quantify muscles in older adults: A systematic review","volume":"8","author":"Nijholt","year":"2017","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.clnesp.2019.01.001","article-title":"The added value of ultrasound muscle measurements in patients with COPD: An exploratory study","volume":"30","author":"Nijholt","year":"2019","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-G\u00f3mez, J.J., Garc\u00eda-Beneitez, D., Jim\u00e9nez-Sahag\u00fan, R., Izaola-Jauregui, O., Primo-Mart\u00edn, D., Ramos-Bachiller, B., G\u00f3mez-Hoyos, E., Delgado-Garc\u00eda, E., P\u00e9rez-L\u00f3pez, P., and De Luis-Rom\u00e1n, D.A. (2023). Nutritional Ultrasonography, a Method to Evaluate Muscle Mass and Quality in Morphofunctional Assessment of Disease Related Malnutrition. Nutrients, 15.","DOI":"10.3390\/nu15183923"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"de Luis Roman, D., Garc\u00eda Almeida, J.M., Bellido Guerrero, D., Guzm\u00e1n Rolo, G., Mart\u00edn, A., Primo Mart\u00edn, D., Garc\u00eda-Delgado, Y., Guirado-Pel\u00e1ez, P., Palmas, F., and Tejera P\u00e9rez, C. (2024). Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk. Nutrients, 16.","DOI":"10.3390\/nu16111552"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Sahathevan, S., Khor, B.H., Singh, B.K.S., Sabatino, A., Fiaccadori, E., Daud, Z.A.M., Ali, M.S., Narayanan, S.S., Tallman, D., and Chinna, K. (2020). Association of Ultrasound-Derived Metrics of the Quadriceps Muscle with Protein Energy Wasting in Hemodialysis Patients: A Multicenter Cross-Sectional Study. Nutrients, 12.","DOI":"10.3390\/nu12113597"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Nagy, E., Samaan, E., El-Gamal, M., Shamsuddin, M., and Tharwat, S. (2024). Concordance between muscle mass assessed by bioelectrical impedance analysis and by muscle ultrasound: A cross-sectional study in a cohort of patients on chronic hemodialysis. BMC Nephrol., 25.","DOI":"10.1186\/s12882-024-03487-0"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.clnu.2020.07.025","article-title":"The clinical applicability of ultrasound technique for diagnosis of sarcopenia in hemodialysis patients","volume":"40","author":"Matsuzawa","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Garc\u00eda, C., Vegas-Aguilar, I.M., Rioja-V\u00e1zquez, R., Cornejo-Pareja, I., Tinahones, F.J., and Garc\u00eda-Almeida, J.M. (2023). Rectus Femoris Muscle and Phase Angle as Prognostic Factor for 12-Month Mortality in a Longitudinal Cohort of Patients with Cancer (AnyVida Trial). Nutrients, 15.","DOI":"10.3390\/nu15030522"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1016\/j.clnu.2016.03.020","article-title":"Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients","volume":"35","author":"Vogt","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/j.clnu.2022.03.025","article-title":"Association between sarcopenia and clinical outcomes in chronic kidney disease patients: A systematic review and meta-analysis","volume":"41","author":"Ribeiro","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s40620-022-01553-0","article-title":"Muscle fat infiltration in chronic kidney disease: A marker related to muscle quality, muscle strength and sarcopenia","volume":"36","author":"Avesani","year":"2023","journal-title":"J. Nephrol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.clnesp.2023.04.015","article-title":"Ultrasound assessment of rectus femoris pennation angle and echogenicity. Their association with muscle functional measures and fat infiltration measured by CT scan","volume":"55","author":"Bunout","year":"2023","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"104759","DOI":"10.1016\/j.msard.2023.104759","article-title":"Ultrasound measures of muscle morphology in people with multiple sclerosis are associated with muscle performance and functional mobility","volume":"75","author":"Seamon","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/ggi.13137","article-title":"Markers of nutritional status and mortality in older adults: The role of anemia and hypoalbuminemia","volume":"18","author":"Corona","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1016\/j.clnu.2021.01.028","article-title":"ESPEN Guideline ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease","volume":"40","author":"Fiaccadori","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cger.2010.08.009","article-title":"The frailty syndrome: Definition and natural history","volume":"27","author":"Xue","year":"2011","journal-title":"Clin. Geriatr. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/MNH.0000000000000364","article-title":"The impact of frailty on outcomes in dialysis","volume":"26","author":"Sy","year":"2017","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"447","DOI":"10.3747\/pdi.2017.00271","article-title":"Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation","volume":"38","author":"Kamijo","year":"2018","journal-title":"Perit. Dial. Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"100989","DOI":"10.1016\/j.xkme.2025.100989","article-title":"Sarcopenia in Peritoneal Dialysis: Prevalence, Pathophysiology, and Management Strategies","volume":"75","author":"Hu","year":"2025","journal-title":"Kidney Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1093\/ckj\/sfad130","article-title":"Effects of oral nutritional supplements on the nutritional status and inflammatory markers in patients on maintenance dialysis: A systematic review and meta-analysis of randomized clinical trials","volume":"16","author":"Liu","year":"2023","journal-title":"Clin. Kidney J."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.clnesp.2021.04.027","article-title":"The effects of amino acid\/protein supplementation in patients undergoing hemodialysis: A systematic review and meta-analysis of randomized controlled trials","volume":"44","author":"Matsuzawa","year":"2021","journal-title":"Clin. Nutr. ESPEN."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"Stevens","year":"2024","journal-title":"Kidney Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/6\/1044\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:47:17Z","timestamp":1760032037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/6\/1044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,5]]},"references-count":79,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["medicina61061044"],"URL":"https:\/\/doi.org\/10.3390\/medicina61061044","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,5]]}}}